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Systematic review with meta analysis
Early laparoscopic cholecystectomy appears better than delayed laparoscopic cholecystectomy for patients with acute cholecystitis
  1. Kurinchi Gurusamy
  1. UCL, London, UK
  1. Correspondence to : Dr Kurinchi Gurusamy, Royal Free Campus, UCL Medical School, 9th Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF, UK; k.gurusamy{at}ucl.ac.uk

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Commentary on: Wu XD, Tian X, Liu MM, et al. Meta-analysis comparing early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg 2015;102:1302–13.

Context

Acute cholecystitis, also known as inflammation of the gallbladder, can be broadly classified as either acute calculous cholecystitis (caused by gallstones)1 or acute acalculous cholecystitis (following serious illness such as systemic sepsis or major surgery).2 Cholecystectomy is mainly indicated in acute calculous cholecystitis,1 while percutaneous cholecystostomy is used as the definitive treatment in the absence of gallstones for patients with acalculous cholecystitis.2 The timing of cholecystectomy (which is usually performed laparoscopically)1 is a matter of significant controversy in patients with acute calculous cholecystitis. While delayed laparoscopic cholecystectomy (DLC) increases the risk of further gallstone-related complications during the waiting period, early laparoscopic cholecystectomy (ELC) is a more complex surgery and there were concerns about the safety of ELC during the early days of …

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